The study of efficacy of Botulinum toxin A in hemifacial spasm in Trang Hospital
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Abstract
BACKGROUND: Hemifacial spasm (HFS) is a common movement disorder in Thailand. It can result in physical disability as well as emotional and social problems of the patients. Although botulinum toxin A is currently used for the treatment of HFS, there are still very few published clinical reports of its efficacy and studies on the quality of life before and after its use.
OBJECTIVES: To evaluate the impact of botulinum toxin A on the function, quality of life, and its efficacy, as well as investigate its side effects in HFS in Trang Hospital, Trang Province, Thailand for a period of 10 years.
METHODS: A retrospective and descriptive study was used to evaluate the treatment outcomes of HFS patients in the Department of Physical Medicine and Rehabilitation in Trang Hospital. The evaluation of the treatment efficacy included the assessment of the peak improvement (0 - 100%) subjectively evaluated at 28 days after the injection session by each patient, the response time to the treatment, and the results and side effects of the treatment. The patients treated with botulinum toxin A were evaluated for the treatment before and 28 days after receiving their first injection by answering the questionnaires: the six - point disability scale and the Thai HFS - 30. In this study, the analysis of the data was performed by descriptive statistics and the Wilcoxon matched - pairs signed ranks test.
RESULTS: A total of 56 patients with HFS were treated with 824 botulinum toxin A treatments. The mean duration of the symptoms was 3.5 years. The sites of injection were the orbicularis oculi and orbicularis oris muscles. The mean dose of all treatments was 22.1 units. The peak improvement of the treatment was assessed between four and six weeks after the first botulinum toxin A injections was 84.6%. There was a statistically significant improvement in the six - point disability rating scale and Thai HFS - 30 in the duration before the treatment. The most common side effect was facial paresis (2.3%). All side effects were transient and lasted from one to four weeks after the injections.
CONCLUSIONS: Botulinum toxin A proved to be an effective treatment for HFS, and it also yielded an improvement in the quality of life of the patients in Trang Hospital.
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References
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